<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Business_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-business_id" data-rule="required" data-source="brand/business/index" class="form-control selectpage form-control" name="row[business_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Auth_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-auth_time" data-rule="required" class="form-control datetimepicker form-control" data-date-format="YYYY-MM-DD" data-use-current="true" name="row[auth_time]" type="text" value="{:date('Y-m-d')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Baozhengjin')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-baozhengjin" data-rule="required" class="form-control form-control" name="row[baozhengjin]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label for="c-zhizhao" class="control-label col-xs-12 col-sm-2">{:__('Zhizhao')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-zhizhao" class="form-control" size="50" name="row[zhizhao]" type="text" value="">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-zhizhao" class="btn btn-danger plupload" data-input-id="c-zhizhao" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-zhizhao"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-zhizhao" class="btn btn-primary fachoose" data-input-id="c-zhizhao" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-zhizhao"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Fanwei')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-fanwei" class="form-control  form-control" rows="5" name="row[fanwei]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
